|l—-J Diabetic foot ulcers are a major source of distress, disability and cost. They do not respond well to treatment and only a third of unselected ulcers heal within three months. The recurrence rate is high and up to one-third of patients require some form of amputation. The most frequent underlying aetiologies are neuropathy, peripheral arterial disease and foot deformity. Chronic diabetic ulcers exhibit specific differences in the cellular infiltrate and rate of expression of extracellular matrix proteins compared with normal healing ulcers. Thus prevention of ulcer should be emphasized during routine diabetes consultation. The main aim in the treatment of diabetic foot ulcers is to obtain ulcer closure. A multidisciplinary approach should include pressure offloading, frequent wound debridement, treatment of infection and appropriate intervention to improve lower limb blood supply.
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